OBJECTIVETo investigate the clinicopathological characteristics, surgical treatment and prognosis of gastrointestinal stromal tumors(GIST).

METHODSThe clinicopathological data of 84 patients with GIST undergone resection between April 1997 and June 2008 were analyzed retrospectively, and the prognosis was evaluated.

RESULTSOut of 84 cases, 42 tumors located in stomach, 24 in small intestine, 18 in other sites. Tumor sizes ranged from 0.5 to 25 cm(average 5.6 cm). Positive rate of CD117 expression determined by immunohistochemical methods was 96.4%. Seventy-nine cases underwent complete tumor resection, while 5 cases received palliative resection or biopsy. Seventy-eight patients were followed up and their 1-, 3-, 5-year survival rates were 92.0%, 79.2%, 72.0% respectively. The Fletcher's classification of malignancy risk groups for GIST was related to the survival rates(P=0.001). The differences of survival rate among very low risk group, low risk group and high-risk group were significant(P=0.003, P=0.000).

CONCLUSIONSComplete tumor resection in the initial operation of GIST should be emphasized. The Fletcher's classification of malignancy risk groups for GIST is related to the survival rate. Extended surgical resection is required for GIST of higher malignancy risk.

Adult ; Aged ; Aged, 80 and over ; Female ; Gastrointestinal Stromal Tumors ; mortality ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Survival Rate

OBJECTIVETo investigate the effects and prognosis of surgical treatment in primary gastrointestinal stromal tumors (GIST).

METHODSThe clinicopathological data of 73 patients with primary GIST underwent operation from April 1997 to December 2007 was retrospectively analyzed, and the prognosis was evaluated too.

RESULTSAmong the 73 cases, 68 cases received complete tumor resection, among which 12 cases underwent laparoscopic operation; while palliative resection and biopsy only were carried out in the other 5 cases. There was significant difference in survival rate between the two groups (P = 0.000). The 1-, 3-, 5-year survival rates of the 66 cases had been followed up was 91.0%, 78.2% and 74.1%, respectively. The malignancy risk grades of GIST was related to the survival rates on statistical analysis (P = 0.002). Significant differences were found in the survival rates between the patients with very low grade, low grade and high grade malignancy tumors (P = 0.012, 0.002).

CONCLUSIONSComplete tumor resection should be emphasized in primary GIST, and more attention should be paid to the initial surgical treatment. Extended surgical resection is required for tumors of higher malignancy risk. The indications of laparoscopic surgery in GIST should be selected with caution for tumor complete resection.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; surgery ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Analysis

OBJECTIVETo evaluate the serum concentrations of E- selectin, integrinbeta(1) subunit and intercellular adhesion molecule-1 in gastric cancer patients and their clinicopathological significance.

METHODSThe serum levels of adhesion molecules E- selectin,intercellular adhesion molecule- 1 (ICAM- 1), and integrinbeta(1) were measured by enzyme-linked immunosorbent assay (ELISA) in 47 health subjects (control group) and in 57 patients with gastric cancer (gastric cancer group) before operation and 7 days after operation. Serum levels of above three factors were compared between the two groups.

RESULTSThe serum concentrations of E- selectin, integrinbeta(1) subunit and ICAM- 1 were higher in gastric cancer group with positive rate of 24.6% ,33.3% ,28.1% respectively. ICAM- 1 and integrinbeta(1) were significant higher in gastric cancer group than that in the control group (P< 0.01),but there was no significant difference in E- selectin between two groups (P=0.64). Serum concentrations of E-selectin, ICAM-1,and integrinbeta(1) were significantly correlated with clinicopathological features as following: clinicopathological stage,invasion depth,lymph node involvement,and presence of distant metastases(P< 0.05,P< 0.01). The serum levels of E- selectin, ICAM- 1, and integrinbeta(1) were decreased significantly after radical resection of gastric cancer,but not in patients with unresectable tumor. Elevated levels of three molecules were significant prognostic factors for patients with gastric cancer,but it could not independently be used to evaluate tumor stage.

CONCLUSIONSSerum concentrations of E- selectin, ICAM- 1,and integrinbeta(1) may reflect tumor progression and metastasis.

Adult ; Aged ; Biomarkers, Tumor ; blood ; E-Selectin ; blood ; Female ; Humans ; Integrin beta1 ; blood ; Intercellular Adhesion Molecule-1 ; blood ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Serum ; metabolism ; Stomach Neoplasms ; metabolism ; pathology

OBJECTIVETo compare the surgical outcomes between laparoscopic and open wedge resection for gastrointestinal stromal tumors of the stomach.

METHODSClinical data of 18 cases undergoing laparoscopic wedge resection from June 2000 to August 2009 at the Zhejiang Provincial People's Hospital were compared with 30 patients treated by open surgery. The perioperative parameters and prognosis data of the two groups were compared.

RESULTSCompared to the open group, laparoscopic group was found with longer operative time, less blood loss, less requirement of postoperative analgesia, earlier resumption of oral intake, earlier return of first flatus, and shorter postoperative hospital stay(all P<0.05). There were no postoperative deaths in both groups. Postoperative complication rate was significantly lower in the laparoscopic group(5.5% vs. 33.3%, P<0.05). The postoperative recurrence rates were 11.8%(2/17) and 10.7%(3/28); the 5-year survival rates were 78% and 63%, respectively, and the difference was not statistically significant(P>0.05).

CONCLUSIONLaparoscopic wedge resection is a feasible treatment option for GISTs of the stomach.

Adult ; Female ; Gastrectomy ; methods ; Gastrointestinal Stromal Tumors ; diagnosis ; pathology ; surgery ; Humans ; Laparoscopy ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

OBJECTIVETo evaluate the impact of reconstruction techniques after subtotal gastrectomy on postoperative glucose and insulin levels after oral glucose tolerance test (OGTT).

METHODSDistal gastrectomy was performed in 38 Beagle dogs. Reconstruction techniques used included integral continual jejunal interposition (n=9), Billroth I( (n=6), Billroth II( (n=7), and isolated jejunal interposition (n=8). Eight controls were used. OGTT was conducted to examine the changes in glucose and insulin levels.

RESULTSCompared to controls, glucose significantly increased in all the 4 operative groups and peaked at 60 min. Billroth II( was associated with the most significant increase. Insulin level significantly increased in all the experimental groups in response to food stimulus and peaked at 60 min. However, the increase of insulin in Billroth II( group was not as prominent as in other groups.

CONCLUSIONSFluctuation of blood glucose after gastrectomy may be mitigated and insulin elevated if duodenal passage is preserved. Continual jejunal interposition should be given priority when Billroth I( reconstruction is not feasible.

Animals ; Blood Glucose ; metabolism ; Digestive System Surgical Procedures ; methods ; Dogs ; Female ; Gastrectomy ; methods ; Glucose Tolerance Test ; Insulin ; blood ; Male

OBJECTIVETo evaluate nutritional status, myoelectrical activity, and gastrointestinal tract emptying capacity after integral continuous jejunal interposition following subtotal gastrectomy.

METHODSAccording to different re-construction techniques, 30 Beagle dogs were divided into four groups after subtotal distal gastrectomy: group 1(n=9, integral continuous jejunal interposition), group 2(n=6, Billroth I(), group 3(n=7, Billroth II(), group 4(n=8, isolated jejunal interposition). Blood cell counts, liver function, myoelectrical activity and the rate of gastrointestinal tract emptying were compared among the four groups.

RESULTSAt week 12 after operation, the body weight in group 1 [(9.65±1.54) kg] was significantly higher than that in group 2[(9.25±1.76)kg], group 3[(9.31±1.54)kg] and group 4[(7.77±1.46)kg]. At week 4, the prognostic nutritional index in group 1(2671.9±49.9) was significantly higher than that in group 3(2555.9±54.7) and group 4(2440.9±54.3), but similar to that in group 2(2791.8±54.3). At week 6, the fasting and postprandial frequency of jejunal pacesetter potentials in group 1 were higher than those in group 3 and group 4(P<0.05) but comparable with those in group 2. The emptying rate of food in the four groups were 95.4%, 91.3%, 93.1% and 94.2%, respectively and there were no significant differences(P>0.05). However, as compared with group 2 and group 3, group 1 had longer operative time and later regular diet resumption, more severe abdominal adhesion(P<0.05).

CONCLUSIONContinuous jejunal interposition should be considered when Billroth I( is not feasible after subtotal gastrectomy.

Anastomosis, Surgical ; methods ; Animals ; Digestive System Surgical Procedures ; methods ; Dogs ; Female ; Gastrectomy ; methods ; Gastric Emptying ; physiology ; Gastroenterostomy ; Male ; Myoelectric Complex, Migrating ; physiology ; Nutritional Status ; Postoperative Period

OBJECTIVETo develop a novel single nucleotide polymorphism (SNP)-PCR based method for quantitative detection of chimerism after allogeneic haemopoietic stem cell transplantation (allo-HSCT), and to explore its feasibility, accuracy and superiority.

METHODS18 SNP loci were sereened to identify informative markers for detecting chimerism in each donor/recipient pair before transplantation. Then the chimerism rate of each informative marker was analyzed by real-time quantitative PCR (RQ-PCR). The accuracy and sensitivity were verified by multiple proportion dilution and analogy chimerism compared with quantitative detection of short tandem repeat (STR)-PCR, fluorescence in situ hybridization (FISH) and fusion gene.

RESULTS(1) The average slope of the 17 time amplications of the internal control plasmid was -3.39, the average intercept was 39.97, correlation coefficients were more than 0.995, which was close to the theoretical level. The intra- and interassay variability was 0.50% and 1.1%, respectively, which were both in the allowed ranges. A linear correlation with artificial mixed chimerism is above 0.99 and a sensitivity of 0.01% proved reproducible. (2) At least one informative marker could be found in over 95% of 40 donor/recipient pairs. The results of the chimerisms derived from SNP-PCR were consistent with that from STR-PCR (96.7%), FISH and fusion gene analasis (P > 0.05); the quantitative results of special fusion gene transcripts were negtive in complete chimerism samples, and positive in mixed chimerism samples.

CONCLUSIONSThis new assay which overcome the PCR competition and plateau biases of STR-PCR provides an accurate, reliable and rapid quantitative assessment of mixed chimerism after allo-transplantation. It is highly promising for of clinical application and may take the place of STR-PCR in the conventional chimerisim assessment.

Chimerism ; Hematopoietic Stem Cell Transplantation ; Humans ; In Situ Hybridization, Fluorescence ; Polymorphism, Single Nucleotide ; Stem Cell Transplantation ; Transplantation Chimera ; Transplantation, Homologous

OBJECTIVETo study the effect of perforator flaps of medial head of gastrocnemius muscle on repairing popliteal fossa scar wounds.

METHODSTen patients with scar in popliteal fossa hospitalized from January 2005 to January 2010 were repaired with perforator flaps of medial head of gastrocnemius muscle. The scar was resulted from burn in 8 patients, and from operation in 2. The duration of the scar was 3 months to 11 years, and area of the scar ranging from 6 cm × 3 cm to 10 cm × 6 cm. Ultrasonic Doppler was used to detect the musculocutaneous perforator vessel of the medial sural artery at the position 10 to 17 cm from the fold of the popliteal fossa and 2 to 5 cm from the posterior midline before surgery. Then flap transplantation surgery was performed. Donor site wounds with width less than 5 cm were sutured directly, and those wider than 5 cm were repaired with skin transplantation.

RESULTSAll the flaps survived. Flap size ranged from 7 cm × 5 cm to 12 cm × 7 cm. All patients were followed up for 3 to 30 months, and the flaps were found to have a good appearance. Patients could walk with heavy load without lameness. The function of knee joint of the affected limb was the same as that of the opposite limb. No obvious depression was observed in donor sites.

CONCLUSIONSThe perforator flaps of medial head of gastrocnemius muscle can be used to repair the popliteal fossa scar wound with satisfactory result.

Adolescent ; Adult ; Child ; Cicatrix ; surgery ; Female ; Humans ; Knee ; Male ; Muscle, Skeletal ; transplantation ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps ; Young Adult

HPV16 L1 gene was amplified from HPV16 positive vaginal secretion sample by PCR, and inserted into pTO-T7 to obtain the recombinant expression vector pTO-T7-HPV16-L1. Then, the pTO-T7-HPV16-L1 was transformed into E. coil strain ER2566 and the recombinant protein HPV16 L1 was expressed in soluble form. After purification by ammonium sulfate precipitation, ion-exchange chromatography, and hydrophobic interaction chromatography, the recombinant protein HPV16 L1 had a purity of more than 98%. By removing DTT, purified HPV16 L1 proteins self-assembled in vitro into VLPs with the diameter of 50 nm. The vaccination experiments on experimental animals showed the VLPs could elicit high titer of neutralizing antibodies against HPV 16. HPV16 VLPs with high immunogenicity and high purity can be produced easily and effectively from an E. coli expression system in the study, and thus can be used in structure investigation and HPV16 vaccine development.
Animals ; Antibodies, Viral ; immunology ; ultrastructure ; Capsid Proteins ; genetics ; immunology ; isolation & purification ; Goats ; Human papillomavirus 16 ; genetics ; immunology ; ultrastructure ; Humans ; Male ; Oncogene Proteins, Viral ; genetics ; immunology ; isolation & purification ; Papillomavirus Infections ; immunology ; virology ; Rabbits ; Recombinant Proteins ; genetics ; immunology ; Vaccination ; Virion ; genetics ; immunology

The effect of topical propranolol gel on the levels of plasma renin, angiotensin II (ATII) and vascular endothelial growth factor (VEGF) in superficial infantile hemangiomas (IHs) was investigated. Thirty-three consecutive children with superficial IHs were observed pre-treatment, 1 and 3 months after application of topical propranolol gel for the levels of plasma renin, ATII and VEGF in Department of General Surgery of Dongfang Hospital from February 2013 to February 2014. The plasma results of IHs were compared with those of 30 healthy infants of the same age from out-patient department. The clinical efficiency of topical propranolol gel at 1st, and 3rd month after application was 45%, and 82% respectively. The levels of plasma renin, ATII and VEGF in patients pre-treatment were higher than those in healthy infants (565.86 ± 49.66 vs. 18.19 ± 3.56, 3.20 ± 0.39 vs 0.30 ± 0.03, and 362.16 ± 27.29 vs. 85.63 ± 8.14, P < 0.05). The concentrations of VEGF and renin at 1st and 3rd month after treatment were decreased obviously as compared with those pre-treatment (271.51 ± 18.59 vs. 362.16 ± 27.29, and 405.18 ± 42.52 vs. 565.86 ± 49.66 P < 0.05; 240.80 ± 19.89 vs. 362.16 ± 27.29, and 325.90 ± 35.78 vs. 565.86 ± 49.66, P < 0.05, respectively), but the levels of plasma ATII declined slightly (2.96 ± 0.37 vs. 3.20 ± 0.39, and 2.47 ± 0.27 vs. 3.20 ± 0.39, P > 0.05). It was indicated that the increased renin, ATII and VEGF might play a role in the onset or development of IHs. Propranolol gel may suppress the proliferation of IHs by reducing VEGF.
Administration, Cutaneous ; Adrenergic beta-Antagonists ; therapeutic use ; Angiotensin II ; blood ; Case-Control Studies ; Female ; Gels ; Hemangioma, Capillary ; blood ; blood supply ; drug therapy ; pathology ; Humans ; Infant ; Infant, Newborn ; Male ; Propranolol ; therapeutic use ; Renin ; blood ; Skin Neoplasms ; blood ; blood supply ; drug therapy ; pathology ; Treatment Outcome ; Vascular Endothelial Growth Factor A ; blood